The effects of acute infectious hepatitis and cirrhosis of the liver on the nonerythropoietic component of early bilirubin.

The nonerythropoietic component of early labeled bilirubin in plasma and bile was studied in 7 patients with acute infectious hepatitis during the late convalescent stage, in 13 patients with Laennec-type liver cirrhosis, and in 7 control subjects after intravenous injection of a tracer dose (2.5 muCi) of 4-14C-delta-aminolevulinic acid (14C-deltaALA). All subjects were examined during the nonicteric stage. In control subjects, the mean cumulative radioactivity readings in 4 hours were 29.6 +/- 4.7 X 10(3) d.p.m. per milligram times 4 hours in plasma and 27.0 +/- 1.2 X 10(3) d.p.m. per milligram times 4 hours in bile. In acute infectious hepatitis patients, the mean cumulative radioactivity readings for both plasma and bile in 4 hours were approximately twice that found in control subjects. In mild cirrhotic patients with enlarged liver on scintigram, the mean cumulative radioactivity readings for both plasma and bile were approximately 1.4 times that in control subjects. In patients with more advanced cirrhosis and markedly small livers on scintigram, the mean cumulative radioactivity readings for both plasma and bile were as low as approximately 0.5 that of control subjects. These findings seem to indicate the important role of the liver in the production of the nonerythropoietic component of early bilirubin in man.